Some patients’ ambulance trips are paid for by Medicaid, the state’s health insurance program for the poor.

Illinois, though, is $2.5 billion behind on its Medicaid payments.

America Ambulance alone is owed $300,000.

Ross said that’s money the company could use.

ROSS: “You’re talking about two really, really nice, brand-new ambulances, fully stocked. Or that money can go elsewhere. That’s quite a few salaries of people we could potentially, you know, hire on.”

Across the state, EMS operations, particularly in rural areas, face similar, or even worse, financial problems.

The Jackson County Ambulance Service, in Southern Illinois, says the state’s low reimbursement rates don’t always cover the cost of supplies like medicine, or the cost of gasoline when EMTs have to drive long distances for a call.

The service’s director says for now, revenue from property taxes has covered the gap.

In Towanda, the fire department says a lack of money has forced it to cut back services to weeknights and weekend.

Towanda outsources to Bloomington’s fire department the rest of the time.

Lieutenant Governor Sheila Simon says longer response times can be a matter of life and death.

SIMON: “Rural EMS providers have to consolidate, particularly if they have to change their base location. That can mean longer times for the ambulance to get to the person who’s in need and a longer time to get back to a health care facility.”

Simon helped a special Illinois House committee examine the problems emergency operations face.

Lawmakers made a series of recommendations, like asking the state to find new revenue sources.

But that’s easier said then done.

Representative Donald Moffitt, a Republican from Gilson who co-chaired the committee, has introduced a measure that would increase the surcharge on cell phones bills, 73-cents cents to $1.

Most of the fee would go to 911 authorities.

But Moffitt said a lack of money isn’t the only problem EMS operations face.

MOFFITT: “We heard of situations of individuals who’ve served in the military, been in combat zones, had been medical officers in a combat situation, trained to high levels for battlefield rescue. And yet in civilian life, maybe they were just an EMT. So when they come back to civilian life, they can only use EMT skills when responding.”

In February, Governor Pat Quinn signed an executive order that will allow military experience to count towards getting a paramedic license

That will take months to implement, though.

In the meantime, EMS operations have benefited from some rule changes.

High school students are now able to volunteer with paramedics as “provisional first responders.”

The program creates larger staffs, while encouraging the next generation of paramedics.

There also used to be a state rule that required two emergency responders be on hand before an ambulance could leave the station to answer a call.

Two EMTs are still required for calls, but now only one medic has to be on board, and another can meet the ambulance at the scene.

Representative Moffitt said that leads to faster response times and better chances of survival.

MOFFITT: “Person had a heart attack, their heart has stopped. Rule of thumb that I’ve been told is that each minute of delay reduces the chance of survival by 10-percent. So four minute delay, 40% chance it won’t be a satisfactory outcome.”

So far, America Ambulance hasn’t had to worry about any budget crunches.

That meant a full EMT team was dispatched to help the elderly Springfield woman whose nurse called 911.

After receiving basic first aid in the ambulance, she arrived at a local hospital for further treatment, all less than a half-hour after the call.